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This article considers the role of treatment in the provision of mental health care in England and Wales. The current legislative position with regard to the making of treatment choices following compulsory commitment will be examined. Consideration will also be given to the position of the informal hospitalised patient, as in the case of R v. Bournewood Community and Mental Health NHS Trust, ex parte L and finally, the role of the common law in establishing (in)capacity in relation to the non-consensual provision of treatment for physical conditions. Attention will then be given to the reform process, which is currently ongoing in England and Wales, and its likely impact on treatment provision. The Mental Capacity Act 2005 received Royal Assent on the 7th April 2005, while the draft Mental Health Bill 2004 underwent detailed examination by the Joint Scrutiny Committee, a report of which was published on the 23rd March 2005. On the 13th July 2005 the British Government outlined its response following the publication of the Scrutiny Committee's recommendations and despite it accepting many of the recommendations put forward, some significant areas of concern remain making the draft Mental Health Bill 2004 "a long way from acceptable legislation".

At the end of the last term of legislation the health promotion law which had passed Parliament (Bundestag) finally failed as it was not agreed upon by the States (Länder). The complex interrelation between federal level, states and social insurance organisations was neglected. The coalition of Christian Democrats and Social Democrats which was formed in autumn 2005 has agreed to launch a health promotion law, but precise statements to contentious issues are missing.

Privacy regulation in Australia, whether by federal or state legislation or other means, has provoked complaints from researchers. Its scope depends on defining the information it covers, the organisations it governs and the principles it applies. Regulation is inconsistent, and compliance can be complex (as illustrated by a hypothetical research example). National reform to achieve a realistic, balanced, publicly acceptable and consistent regulation is urgently needed, and has been recognised and recommended by recent reviews of the Commonwealth Privacy Act 1988 (Cwlth) by the Office of the Federal Privacy Commissioner and the Australian Senate.

The Organ Transplant Law of Japan, which regulates organ transplants using brain-dead persons' organs, has a set of extremely severe intention-requirements. It has stagnated, rather than promoted, the organ transplant in Japan for the last 8 years. We believe that the Law should be reformed by making an about-face from the current "opt-in" to the "opt-out" principle.

The federal government is making a significant contribution to the treatment of adolescents with substance use disorders. However, funds are scattered across a number of policy domains. While some federal policies are complementary, many overlap, illustrating not only the complexity of collaborative efforts on the part of the implementing federal agencies but also the diversity of partnerships supporting adolescent substance use treatment. Changes in the organization and financing of health care delivery, coupled with the complex interaction of federal policies that address this population, affect the efficiency and effectiveness of federal policy responses to the problem. Equally important are the gaps in federal policy and the inadequacy of federal programs to reach all youth in need. This article analyses existing federal policies and programs and concludes that a seamless, multidisciplinary system that transcends traditional federal policy boundaries must be designed and implemented.

According to current jurisdiction any intervention of the physical integrity of the body, even medical treatment and the administration of medication, constitutes a physical injury. The legal authority for this primarily comes from the consent of the patient. The problem for the medical doctor is whose consent is necessary when the patient is a minor. According to the jurisdiction and the literature, the consent of a minor to medical treatment is a legally binding decision not dependent on reaching the age of majority. Nevertheless, according to the overwhelming opinion it can be assumed that minors under the age of 14 years old are not yet capable of consent. The authority for consent lies with the parents or guardians. Because children are normally only accompanied by one of the parents when visiting a doctor, in routine practice the 3-stage theory developed by the Federal High Court pays a deciding role. According to this theory, for routine cases the doctor can assume that one of the parents is basically a representative of the other: for more complicated or severe cases the doctor must satisfy himself that this is true. For patients over 14 years old, the doctor must ascertain whether the patient is capable of consent. Even though a 15-year-old patient for example, can possess the necessary power of judgement and therefore be considered capable of consenting to routine measures or simple interventions, such as taking a blood sample, the yardstick for higher-risk operations, even routine ones is much higher.

For the implementation of the Framework Council Directive 91/414/EEC, participation of all member states (MS) is required. In the first round of the review program of plant protection products, Mediterranean countries have successfully performed their proportional work share for the central registration of the active substances and the national registration of the respective plant protection products. However, some issues of risk assessment, related to appropriate estimation of exposure, still require further refinement and adaptation to the Mediterranean conditions. Issues related to the estimation of agricultural worker exposure to plant protection products due to different agronomic practices and conditions, identified shortcomings in the consumer risk assessment related to different habits of the Mediterranean population and different needs of Mediterranean agriculture will be discussed. Finally, the possible effects of the Directive 91/414/EEC upon the plant protection of Mediterranean countries, due to the withdrawal from the market of a wide range of plant protection products is also a parameter that has to be considered.

Ten candidate countries are expected to join EU in 2004. In the field of plant protection product (PPP) regulation, at EU level, acceding states will have roles in evaluation for listing of active substances in Annex I of Directive 91/414/EEC and ensuring that at national level, regulatory procedures comply with the acquis communautaire. This paper briefly outlines the impact of the acquis on the roles of Member States at both EU and national levels. It then briefly explains the current Czech Republic regulatory system as operated by the State Phytosanitary Administration and the National Institute of Public Health and the steps that the Czech Republic will have to take to implement the acquis requirements. Finally it makes an assessment as to how successful implementation of the acquis will prove beneficial to the acceding states and the parties which rely on the service that the regulatory authorities provide (i.e. the public, farmers and growers and the agrochemical industry).

This article focuses on certain noteworthy legislation and cases affecting medicine and law during the period September 1, 2001, to August 31, 2002. It does not attempt to discuss every case or piece of legislation, but instead seeks to summarize some of the more significant developments in this area of law.

Since the publication of Directive 2001/20/EC in the Official Journal of the European Communities on May 1, 2001, the Member States have been preparing its transposition into national legislation for application no later than May 2004. The discussions have proved to relate essentially to the organisation of the Ethics Committees, which must now give a single opinion per Member State, as well as to the time limits for obtaining this opinion and the authorization for a study from the competent authority. These considerations have led to proposals of shorter time limits for products at an early stage of development or involving certain diseases. Despite harmonization of the legislation, the application of the Directive does not eliminate all national differences.

In the year 2000 the German legislative decided to implement a case-dependent reimbursement system in an acute inpatient setting beginning in 2003. The German-Diagnoses Related Group System (G-DRGs) will adopt the refined version of the Australian-Diagnoses Related Group System (AR-DRG, version 4.1). Based on empirical data and expertś panels the acute psychiatric hospitals have been exempted from the adoption of the case-based payment system. With regard to national and international experiences in the development of patient classification systems in psychiatry and medical rehabilitation this article illustrates the development of a case group concept for patients with mental disorders.

The first step in the process of regulating cell-based products in Australia was taken in 1991, when the code of good manufacturing practice (cGMP) for 'Blood and Blood Components' was instituted. Paradoxically, it focused on the regulation of plasma fractionation, the non-cellular component of blood. Subsequently, Australia's regulatory body for medicinals, the Therapeutic Goods Administration (TGA), has clearly stated that all cell-based therapies utilizing components of blood and/or tissues will be regulated. The final landscape for the regulation of cellular therapies has yet to be defined, but is likely to be clarified within the next 12 months. The current cGMP for 'Blood and Tissues' is the regulatory document for all aspects of cell processing, including standard blood components (cellular and plasma), cord blood and allogeneic cells for storage. Currently, there are some exemptions to government regulation, and the most important of these is autologous hemopoietic stem cells (HSC). Indeed, no licensing is required for processing of HSC at the moment, although most centers subject themselves to a self-imposed auditing system through the National Association of Testing Authorities, Australia. However, it is anticipated that within 12 months this and the other exemptions within the Act will be removed. The TGA will become the formal regulator of all cell-based therapies, and laboratories will be required to apply for cGMP auditing and licensing. It is likely that the Foundation for the Accreditation of Cellular Therapy (FACT) guidelines or others of a similar nature, will form the basis of one of the regulatory standards for HSC processing. Of particular note is the inclusion of apheresis as an integral component of cGMP licensing.

Should managed care plans have the ability to limit an individual's "freedom of choice" when it comes to selecting a provider? As part of the anti-managed care movement of the early 1990s, 22 states enacted freedom of choice laws; the majority apply only to pharmacies.

Forty-eight states prohibit managed care organizations (MCOs) from limiting a provider's ability to discuss potential treatment options with patients.

A point-of-service (POS) option is a type of plan offered by managed care organizations (MCOs), including health maintenance organizations (HMOs), that allows people who are willing to pay higher out-of-pocket costs to see out-of-plan providers. Mandating a point-of-service option essentially eliminates the use of closed-panel HMOs. This issue brief addresses only bills that mandate managed care plans to offer a point-of-service option.

When a health care provider leaves or is terminated by a managed care plan, how long can patients continue to receive covered treatment from that provider for a life-threatening condition, pregnancy, disability or other circumstance that requires continuous medical care? Lawmakers in 36 states have answered that question.

Objectives: Laws limiting access to sterile syringes impede the public health goal that injection drug users (IDUs) use a new, sterile syringe for every injection to reduce blood-borne disease transmission. We sought to determine the legality of selling or giving syringes to IDUs to prevent disease., Design: We used standard legal research methods to identify and analyze laws and regulations influencing the distribution of syringes in the 50 states, the District of Columbia, Puerto Rico, and the Virgin Islands., Results: A total of 51 jurisdictions had drug paraphernalia laws; 14 had syringe prescription laws or regulations; 11 required purchasers to show identification; 13 had legislation authorizing syringe exchange programs (SEPs). Since the beginning of the human immunodeficiency virus epidemic, 11 states have fully or partially deregulated syringe sales. Nonprescription retail syringe sales to IDUs for disease prevention purposes are clearly legal in 20 states, and have a reasonable claim to legality in 22 more. Sales to IDUs with a prescription are clearly illegal in only 3 jurisdictions. SEPs can operate legally in at least 21 states., Conclusion: Syringe access laws in most states may reasonably be interpreted to allow pharmacists to sell syringes to IDUs to prevent disease. In practice, however, unclear laws and pharmacist uncertainty as to their interpretation may constitute continuing barriers to syringe access for IDUs. A comprehensive public policy of ensuring syringe access for IDUs requires eliminating legal barriers to the sale, possession, and disposal of syringes, and educating pharmacists and law enforcement officials about the legality and public health importance of sterile syringe access.

Objective: To review laws, regulations, and guidelines that affect the collection and disposal of hypodermic needles, syringes, and lancets used outside of professional health care settings (hereafter referred to as "community syringes")., Design: Law and policy analysis., Setting: Alabama, California, Florida, Georgia, Hawaii, Massachusetts, Michigan, Minnesota, New Jersey, New York, Ohio, Oregon, Rhode Island, South Carolina, Washington, and Wisconsin., Intervention: Information on syringe collection and disposal in the community was gathered from federal and state records and state agency personnel., Main Outcome Measures: Legally permissible means of syringe collection and disposal available to persons in the community injecting medical treatments and injection drug users., Results: Laws, regulations, or guidelines in 13 states allowed community syringes to be legally discarded in household trash; guidelines for in-trash disposal varied among the states. Only 6 states had laws or regulations that specifically addressed community syringe collection. In 10 states, infectious waste laws and regulations that apply to medical facilities such as clinics would also apply to community syringe collection sites., Conclusion: In the 16 states studied, laws, regulations, and guidelines relating to community syringe collection and disposal were somewhat inconsistent and confusing and presented potential barriers to safe disposal. States should consider amending laws, regulations, and guidelines to promote community syringe collection programs. A national effort is needed to achieve consistent community syringe collection and disposal laws and guidelines for all states. Pharmacists can aid in safe syringe disposal by counseling their patients about safe disposal, providing or selling sharps containers, and accepting used syringes for safe disposal. Pharmacists can join other interested groups in advocating clarification of disposal laws and regulations that favor community programs designed to keep syringes out of the trash so that they can be disposed of as infectious waste.

The current legal framework within the Lithuanian health system is described including a review of the physician's autonomy, rights and duties, and patients' rights including the right to reimbursement. The role of ethical codes and the law are discussed.

This article addresses important developments in the field of medicine and law during the period of September 1999 through August 2000. Although it does not discuss every reported case or piece of legislation, it broadly surveys some of the more significant developments in the medicine and law arena.

The French system of evaluation of dependence has been defined in the French Public Health Code by decree 99-249 of 31 March 1999. It was created by health authorities 10 years earlier and concerns dependence and abuse, which were previously just submitted to control under the designation of non-conforming use and misuse. The consultative function of the narcotics and psychotropics commission has been reinforced and its mission extended to include evaluation. Cooperation with different actors has been organized. This is based on the complexity of the methods of evaluation and the impact of decisions concerning control and/or information. The same principles organize the cooperation of this system at the European and international levels.